Adherence to the MIND diet is inversely associated with odds and severity of anxiety disorders: a case-control study.

BACKGROUND: The association between the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diet, odds, and severity of anxiety disorders (AD) is still unclear. We aimed to investigate whether adherence to MIND diet is associated with odds and severity of AD. METHODS: The present case-control study carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake was assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. The MIND diet score was calculated using FFQ. We assessed anxiety disorder severity using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of MIND diet and anxiety disorder. RESULTS: We observed that higher adherence to MIND diet was associated with the lower GAD-7 score (p < 0.001). Individuals in the top category of MIND diet score were 97% less likely to have AD compared with those in the bottom category (OR: 0.03, 95% CI: 0.01, 0.09). There was significant reverse linear association between MIND diet score and AD (ß = -3.63, p < 0.001). CONCLUSIONS: In conclusion, we provided some evidence indicating negative association between adherence to MIND diet, odds, and severity of AD. Finally, due to the probable preventive role of diet, it is vital to clarify the association between diet and AD through large-scale prospective cohort studies in the future.

The relationship between dietary lipophilic index and load with depression, anxiety, and stress symptoms.

BACKGROUND: Dietary fatty acids can affect brain health by modifying neuronal membrane fluidity. Dietary lipophilic index (LI) and load (LL) may be related to cell membrane fluidity. This study aimed to determine the relationship between dietary LI and LL with symptoms of depression, anxiety and stress. METHODS: In this cross-sectional study, taken from the YaHS (Yazd Health Study) population-based cohort, the data of 2,982 individuals was extracted. Several questionnaires- a 178-item Food Frequency Questionnaire (FFQ), Depression, Anxiety and Stress Scale 21 (DASS 21), and International Physical Activity Questionnaire (IPAQ)- were used to obtain information on dietary intake, mental status, and physical activity, respectively. LI and LL were calculated using dietary intake and the melting point of each fatty acid. RESULTS: The analysis was performed on 2982 individuals. The odds ratio of depression in the second tertile of dietary LI compared to the first tertile was 0.815 (95% CI 0.66-1.00, P = 0.051, Ptrend = 0.017) and after adjusting confounders was 0.793 (95% CI 0.63-0.99, P = 0.043, Ptrend = 0.011). Also, LL was related inversely with anxiety (0.771, 95% CI 0.63-0.93, P = 0.003) that after multiple regression, OR of anxiety was 0.762 (95% CI 0.53-1.07, P = 0.045). The odds of stress in the third tertile of LL was 1.064 but not statistically significant (95% CI 0.88-1.28, P = 0.729). CONCLUSION: This study showed an inverse association between dietary LI and depression symptoms. Anxiety and stress did not show a significant relationship with LI or LL.

The effects of prognostic factors on transplant and mortality of patients with end-stage liver disease using Markov multistate model.

Background: Decompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident. Materials and Methods: In this historical cohort study, the information from 780 eligible patients aged 18 years or older was analyzed by the Markov multistate model; they had been listed between 2008 and 2014, needed a single organ for initial orthotopic LT, and followed at least for up to 5 years. Results: With a median survival time of 6 (5-8) years, there were 275 (35%) deaths. From 255 (33%) patients who had LT, 55 (21%) subsequently died. Factors associated with a higher risk of mortality and LT occurrence were included: higher model for end-stage liver disease (MELD) score (hazard ratio [HR] = 1.16, confidence interval [CI]: 1.09-1.24 and HR = 1.22, CI: 1.41-1.30) and ascites complication (HR = 2.34, CI: 1.74-3.16 and HR = 11.43, CI: 8.64-15.12). Older age (HR = 1.03, CI: 1.01-1.06), higher creatinine (HR = 6.87, CI: 1.45-32.56), and autoimmune disease versus hepatitis (HR = 2.53, CI: 1.12-5.73) were associated with increased risk of mortality after LT. Conclusion: The MELD and ascites are influential factors on waiting list mortality and occurrence of LT. Total life expectancy is not influenced by higher MELD.

Tumor Microenvironment, Radiology, and Artificial Intelligence: Should We Consider Tumor Periphery?

OBJECTIVES: The tumor microenvironment (TME) consists of cellular and noncellular components which enable the tumor to interact with its surroundings and plays an important role in the tumor progression and how the immune system reacts to the malignancy. In the present study, we investigate the diagnostic potential of the TME in differentiating benign and malignant lesions using image quantification and machine learning. METHODS: A total of 229 breast lesions and 220 cervical lymph nodes were included in the study. A group of expert radiologists first performed medical imaging and segmented the lesions, after which a rectangular mask was drawn, encompassing all of the contouring. The mask was extended in each axis up to 50%, and 29 radiomics features were extracted from each mask. Radiomics features that showed a significant difference in each contour were used to develop a support vector machine (SVM) classifier for benign and malignant lesions in breast and lymph node images separately. RESULTS: Single radiomics features extracted from extended contours outperformed radiologists' contours in both breast and lymph node lesions. Furthermore, when fed into the SVM model, the extended models also outperformed the radiologist's contour, achieving an area under the receiver operating characteristic curve of 0.887 and 0.970 in differentiating breast and lymph node lesions, respectively. CONCLUSIONS: Our results provide convincing evidence regarding the importance of the tumor periphery and TME in medical imaging diagnosis. We propose that the immediate tumor periphery should be considered for differentiating benign and malignant lesions in image quantification studies.

The effect of Cornus mas extract consumption on bone biomarkers and inflammation in postmenopausal women: A randomized clinical trial.

The drastic decrease in estrogen levels in menopausal women can elevate bone resorption and osteoporosis. Cornus mas extract (C. mas extract) is a potential candidate for treating menopausal-related bone complications because of its phytoestrogen and anti-inflammatory contents. It was an interventional double-blind placebo-controlled randomized study. Eighty-four women aged 45-60 years old were randomly allocated to either the extract group receiving 3 capsules of 300 mg C. mas extract or the placebo group receiving 3 capsules of 300 mg of starch powder per day for 8 weeks. Then, venous blood was used to measure bone-specific alkaline phosphatase (BAP), osteocalcin (OC), C-terminal telopeptide (TC) as well as serum levels of PTH and hsCRP. Our results indicated the decrease in alkaline phosphatase, PTH, and as an inflammation biomarker, hsCRP, between two groups at the end of the study. No statistically significant difference was observed in telopeptide C, osteocalcin, and calcium between the placebo and extract groups after 8 weeks of intervention. In conclusion, the results indicate that the C. mas extract supplement of 900 mg/day may decrease levels of BAP, PTH, and hsCRP. However, this intervention had no beneficial effect on OC and TC in healthy postmenopausal women.

Influences of Occupational Burnout and Personality on Lipid Peroxidation Among Nurses in Shahroud City, Iran.

Considering the relationship between occupational burnout and oxidative stress, identifying the factors that affect occupational burnout, such as recognizing individual characteristics, would be beneficial for implementing strategies to reduce oxidative stress levels. This study was conducted on 92 nurses from a hospital in Shahroud, a city in northeastern Iran, who were chosen at random. The data was collected through the Demographic Questionnaire, Maslach Burnout Inventory and Personality Factors Inventory. Each participant's serum markers of oxidative stress were also measured. Total antioxidant capacity (TAC) and neuroticism were found to have a negative relationship in this study. Furthermore, marital status, the ward where nurses work, the type of contract, emotional exhaustion, and depersonalization were all found to be significant predictors of malondialdehyde (MDA). Neuroticism, emotional exhaustion, and depersonalization were the most important predictors of oxidative stress levels.The results of this study suggest that some approaches to reducing oxidative stress can be implemented by identifying the factors influencing occupational burnout and also by recognizing individuals' personality traits.

Effect of lymphedema self-management group-based education compared with social network-based education on quality of life and fear of cancer recurrence in women with breast cancer: a randomized controlled clinical trial.

BACKGROUND: Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. METHODS: This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis. RESULTS: There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively. CONCLUSION: Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. TRIAL REGISTRATION: This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).

The effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active rheumatoid arthritis: A randomized, double-blind, placebo-controlled clinical trial.

Rheumatoid arthritis (RA) is a systemic autoimmune and inflammatory disease. Our study aimed to determine the effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active RA. In this randomized, double-blind, placebo-controlled trial, 66 women older than 18 years old received 100 mg/day either saffron supplement in the intervention group (n = 33) or matched placebo in the placebo group (n = 33) for a period of 12 weeks. Sixty-one patients (30 in the control and 31 in the saffron group) remained for the final analysis. No adverse effects were reported by the patients. Saffron supplementation significantly decreased the number of tender (-1.38 ± 1.66 vs. 0.10 ± 0.40, p < .001) and swollen (-2.12 ± 2.34 vs. 0.63 ± 2.79, p < .001) joints, pain intensity based on visual analogue scale (-18.36 ± 15.07 vs. -2.33 ± 5.04), p < .001), and disease activity score (DAS28) (-0.75 ± 0.67 vs. 0.26 ± 0.77, p < .001) at the end of intervention between the two groups and in saffron group compared with baseline values. Physician Global Assessment (p = .002) and erythrocyte sedimentation rate were significantly improved after intervention (24.06 ± 12.66 vs. 32.00 ± 14.75, p = 0.028). High-sensitivity C-reactive protein reduced at the end of the intervention in the saffron group compared with baseline values (12.00 ± 7.40 vs. 8.82 ± 7.930, p = .004). Tumor necrosis factor alpha, interferon gamma, and malondialdehyde were decreased, and total antioxidant capacity were increased, but their differences between the two groups were not significant (p > .05). According to the results, saffron supplements could positively and significantly improve clinical outcomes in RA patients.

A Hybrid Multilayer Filtering Approach for Thyroid Nodule Segmentation on Ultrasound Images.

OBJECTIVES: Speckle noise is the main factor that degrades ultrasound image contrast and segmentation failure. Determining an effective filter can reduce speckle noise and improve segmentation performances. The aim of this study was to define a useful filter to improve the segmentation outcome. METHODS: Twelve filters, including median, hybrid median (Hmed), Fourier Butterworth, Fourier ideal, wavelet (Wlet), homomorphic Fourier Butterworth, homomorphic Fourier ideal, homomorphic wavelet (Hmp_Wlet), frost, anisotropic diffusion, probabilistic patch-based (PPB), and homogeneous area filters, were used to find the best filter(s) to prepare thyroid nodule segmentation. A receiver operating characteristic (ROC) analysis was used for filter evaluation in the nodule segmentation process. Accordingly, 10 morphologic parameters were measured from segmented regions to find the best parameters that predict the segmentation performance. RESULTS: The best segmentation performance was reached by using 4 hybrid filters that mainly contain contrast-limited adaptive histogram equalization, Wlet, Hmed, Hmp_Wlet, and PPB filters. The area under the ROC curve for these filters ranged from 0.900 to 0.943 in comparison with the original image, with an area under the curve of 0.685. From 10 morphologic parameters, the area, convex area, equivalent diameter, solidity, and extent can evaluate segmentation performance. CONCLUSIONS: Hybrid filters that contain contrast-limited adaptive histogram equalization, Wlet, Hmed, Hmp_Wlet, and PPB filters have a high potential to provide good conditions for thyroid nodule segmentation in ultrasound images. In addition to an ROC analysis, morphometry of a segmented region can be used to evaluate segmentation performances.

The effect of Cornus mas fruit extract consumption on lipid profile, glycemic indices, and leptin in postmenopausal women- A randomized clinical trial.

Menopause, which occurs following a declined ovarian activity and reduced estrogen levels, can lead to long-term changes in lipid and glycemic profiles and increases the risk of cardiovascular disease and osteoporosis. Cornelian cherry (Cornus mas) is rich in phytochemicals and antioxidants, which appears to be useful in reducing the postmenopausal complications. This interventional, double-blinded, randomized clinical trial carried out on 84 menopaused women aged 45-60 years old. They were randomly divided into two groups. The treatment group received three capsules of 300 mg of Cornus mas extract (CME), and control group received three capsules of 300 mg of starch powder per day for 8 weeks. Then, BMI, waist circumference, glycemic indices, lipid profile, serum apoproteinase, apoprotein B100, fibrinogen, and leptin were measured. The dietary intakes were evaluated using 24-hr dietary recall questionnaire. The consumption of CME in comparison with the control group resulted in a significant reduction in weight, body mass index, waist circumference, LDL to HDL ratio, total cholesterol to HDL ratio, and fibrinogen. There was also a significant increase in HDL and ApoA1 levels in the treatment group. Furthermore, there was a significant decrease in BMI, waist circumference, fasting insulin, and insulin resistance index after 8 weeks of using CME. Summing up the results, it can be concluded that CME can have possible effects on decreasing BMI, waist circumference, and improving some aspects of lipid profile and glycemic indices in postmenopausal women.

Relationship Between Noise Annoyance and Cognitive Performance in Automotive Workers Exposed to Chronic Noise.

Among the most important complaints of people exposed to noise are the feelings of resentment and annoyance, and the changes in mental conditions, which are among the main psychological consequences affecting the concentration and accuracy of workers. This study was designed to investigate the relationship between annoyance and cognitive performance of workers exposed to chronic noise. This is a descriptive-analytical study conducted on workers in an automotive company. Three hundred workers exposed to noise were entered into the study in two groups: administrative (150 people) and industrial (150 people). The Tower of London and the Stroop computerized psychological tests were used to determine the cognitive status of the workers, and a questionnaire with numbered questions (numbered 1 to 11) was used in order to determine their level of annoyance. There was a significant correlation between the workers' cognitive performance and annoyance levels (P value <0.001). Linear regression results showed that cognitive performance had a significant relationship with the received sound intensity, while the workers' annoyance had a significant relationship with cognitive performance only in the number of wrong answers, the number of unanswered questions, and the number of correct answers in the Stroop test (P value <0.001). The researchers concluded that exposure to chronic noise in work environments could bring about occupational annoyance, and consequently, cognitive disorders, which could increase the risk of errors. More studies are needed to further explore this relationship.

Vestibular-Balance Rehabilitation in Patients with Whiplash-Associated Disorders.

BACKGROUND AND OBJECTIVE: Whiplash associated syndrome is one of the neck disorders that is accompanied by several chronic symptoms. Balancing problems arising from common disorders and dizziness are considered as manifestations that are time-consuming to evaluate and treat. The present study aims to investigate the effect of vestibular-balance rehabilitation using a test that can be used for differential diagnosis of these lesions by comparing dizziness handicap inventory (DHI) and Smooth Pursuit Neck Torsion (SPNT) scores. METHOD: This was an analytical cross-sectional study with a two-stage design. Forty patients with whiplash-associated disorders were randomly divided into control and intervention groups. SPNT test and DHI evaluation were performed for both groups. For twenty people selected randomly in the intervention group, vestibular-balance rehabilitation was performed during 12 sessions. Finally, the SPNT and DHI tests were performed again to examine and compare the results. RESULTS: The results of this study showed that there was a statistically significant difference between the scores of smooth pursuit neck torsion gain in the SPNT test, the total score of DHI, the functional components of this questionnaire between the control and intervention groups after the implementation of the rehabilitation, and the differences in the physical, functional, and emotional components of the questionnaires of the control and intervention groups after rehabilitation exercises. CONCLUSION: Vestibular-balance rehabilitation exercises can be an effective treatment for dizziness and improving the quality of life of a person suffering from whiplash-associated disorder, followed by the reduction in dizziness caused by disability.

MDCT-QCT, QUS, and DXA in healthy adults: An intermodality comparison.

Background: Cortical deceleration is the main reason for bone loss at peripheral sites. It was suggested that when peripheral bones were assessed for osteoporosis, management and therapy can be administered early. The main aim of this study was to assess the relationships between the central and peripheral measurements at different skeleton bone sites (spine, femur, forearm, tibia, and calcaneus) with available modalities: DXA, QUS, and MDCT-QCT. Methods: The volunteers recruited in this study did not have any history or evidence of metabolic bone disease. Blood test and DXA measurements were used as inclusion criteria to select 40 healthy participants. The selected volunteers underwent 3 imaging modalities: QCT, DXA, and QUS. DXA-based measurements were made on 3 sites, including spine, femur, and forearm. QCT and QUS measurements were done for distal of tibia and calcaneus bones, respectively. The extracted parameters from the 3 modalities were analyzed using a bivariate (Pearson) correlation (r) in statistical software. Results: The results showed moderate to good correlations between spongy bones in central and peripheral sites from all the modalities. However, there was no correlation between MDCT measures and central bone values. According to correlations between different peripheral sits, aBMD of 33% radius and trabecular vBMD in 38% distal tibia showed weak but significant relationship between peripheral bones (r=-0.342, p=0.044). Conclusion: The findings demonstrated how bones in central and peripheral sites were correlated. Multimodality imaging was used in this group of healthy volunteers. Also, it was found that QCT-based MDCT needs more optimization and requires further investigations.

Scintigraphic texture analysis for assessment of renal allograft function.

PURPOSE: Early detection and monitoring of kidney function during the post-transplantation period is one of the most important issues for improving the accuracy of an initial diagnosis. The aim of this study was to evaluate texture analysis (TA) in scintigraphic imaging to detect changes in kidney status after transplantation. MATERIAL AND METHODS: Scintigraphic images were used for TA from a total of 94 kidney allografts (39 rejected and 55 non-rejected). Images corresponding to the frames at the 2nd, 5th, and 20th minute of the study were used to determine the optimum time point for analysis of differences in texture features between the rejected and non-rejected allografts. RESULTS: Linear discriminant analysis indicated the best performance at the fifth minute frame for classification of the rejected and non-rejected allografts with receiver operating characteristic curve (Az) of 0.982, corresponding to 91.89% sensitivity, 96.49% specificity, and 94.68% accuracy. Also, TA can differentiate acute tubular necrosis from acute rejection with Az of 0.953 corresponding to 88% sensitivity, 92.31% specificity, and 90.62% accuracy at the 5th minute frame. The best correlation between texture feature and kidney function was achieved at the 20th minute frame (r = -0.396) for glomerular filtration rate. CONCLUSIONS: TA has good potential for the characterisation of kidney failure after transplantation and can improve clinical diagnosis.

Comparing of Cox model and parametric models in analysis of effective factors on event time of neuropathy in patients with type 2 diabetes.

BACKGROUND: Cox proportional hazard model is the most common method for analyzing the effects of several variables on survival time. However, under certain circumstances, parametric models give more precise estimates to analyze survival data than Cox. The purpose of this study was to investigate the comparative performance of Cox and parametric models in a survival analysis of factors affecting the event time of neuropathy in patients with type 2 diabetes. MATERIALS AND METHODS: This study included 371 patients with type 2 diabetes without neuropathy who were registered at Fereydunshahr diabetes clinic. Subjects were followed up for the development of neuropathy between 2006 to March 2016. To investigate the factors influencing the event time of neuropathy, significant variables in univariate model (P < 0.20) were entered into the multivariate Cox and parametric models (P < 0.05). In addition, Akaike information criterion (AIC) and area under ROC curves were used to evaluate the relative goodness of fitted model and the efficiency of each procedure, respectively. Statistical computing was performed using R software version 3.2.3 (UNIX platforms, Windows and MacOS). RESULTS: Using Kaplan-Meier, survival time of neuropathy was computed 76.6 ± 5 months after initial diagnosis of diabetes. After multivariate analysis of Cox and parametric models, ethnicity, high-density lipoprotein and family history of diabetes were identified as predictors of event time of neuropathy (P < 0.05). CONCLUSION: According to AIC, "log-normal" model with the lowest Akaike's was the best-fitted model among Cox and parametric models. According to the results of comparison of survival receiver operating characteristics curves, log-normal model was considered as the most efficient and fitted model.

Anemia Status Changes Among Patients With Obesity Following Bariatric Surgery.

Objective This study aims to investigate trends in anemia severity among patients with pre-existing anemia who underwent bariatric surgery due to obesity. It also examines how different bariatric surgery techniques impact anemia outcomes. Methods This prospective study included 280 patients aged 18 to 65 with obesity who underwent bariatric surgery. The patients were categorized into three groups based on the type of surgery: sleeve gastrectomy, one-anastomosis gastric bypass, and Roux-en-Y gastric bypass. Anemia severity was evaluated over a 12-month follow-up period. Chi-square tests were used to assess the homogeneity of baseline factors among the groups, and McNemar tests along with generalized estimating equations were used to compare anemia outcomes. Results Before surgery, the rates of moderate anemia across the three surgical groups ranged from 18.2% to 22.4%, with no cases of severe anemia observed. There was no significant difference among the groups (p=0.949). During the 12-month follow-up, the odds ratio for reducing anemia severity in the sleeve gastrectomy and Roux-en-Y gastric bypass groups were 2.13 and 1.91, respectively, compared to the one-anastomosis gastric bypass group. Additionally, the odds ratio for reducing anemia severity in patients with hypothyroidism was 1.84 compared to those without hypothyroidism. Conclusion The choice of bariatric surgery technique significantly affects anemia outcomes, with sleeve gastrectomy showing a higher success rate in reducing anemia severity. The role of hypothyroidism in anemia management also appears to be significant.

The relationship between the level of postural stress, Musculoskeletal Disorders, and chronic fatigue: A case study in the dairy industry.

BACKGROUND: Dairy industry workers face numerous ergonomic risk factors in their workplace, including improper posture, manual material handling, and musculoskeletal disorders (MSDs). Fewstudies have been conducted on the correlation of postural stress, MSDs, and chronic fatigue among workers in the dairy industry. OBJECTIVE: This study aimed to investigate the relationship between the level of postural stress, MSDs, and chronic fatigue in a dairy company. METHODS: In this cross-sectional study, 260 male workers were included in the research based on specific inclusion criteria. The Cornell Musculoskeletal Discomfort Questionnaire, Chalder Fatigue Scale, and a researcher-made demographic questionnaire were used to collect data. The posture of workers was evaluated using RULA and REBA software, and the evaluation of the manual lifting of loads was assessed using the WISHA lifting calculator. Finally, the collected data were entered into the SPSS software version 26.0 and analyzed. RESULTS: The findings revealed a significant statistical relationship between the level of postural stress and chronic fatigue and a significant positive correlation between MSDs and chronic fatigue. Furthermore, a statistically significant relationship was observed between MSDs, chronic fatigue, and ergonomics training experience. CONCLUSIONS: The results obtained in this study support the notion that high levels of postural stress and MSDs can produce an increase in chronic fatigue among workers, and lack of ergonomics training for workers can increase both MSDs and chronic fatigue. Therefore, it is necessary to carry out intervention measures in the field of ergonomics management in similar industries through the implementation of ergonomic intervention programs with a focus on proactive and preventive measures and the use of participatory ergonomic programs and educational demands assessment.

Evaluation of Factors Affecting Neuropathy in Patients With Type 2 Diabetes Using Artificial Neural Networks.

INTRODUCTION: Neuropathy is a common and debilitating complication in type 2 diabetes, affecting quality of life and increasing healthcare costs. Identifying risk factors is essential for early intervention and management. This study aims to evaluate the factors influencing the occurrence of neuropathy in patients with type 2 diabetes using artificial neural networks. METHODS: In this cohort study, data from 371 patients with type 2 diabetes from Fereydunshahr, Iran, were analyzed over a 12-year follow-up period. Participants were selected based on diabetes screenings conducted in 2008 and 2009. Artificial neural networks with varying architectures were trained and validated, and their performance was compared to logistic regression models using receiver operating characteristic (ROC) curve analysis. RESULTS: The prevalence of neuropathy in this cohort study was 31.2%. The best-fitted artificial neural network and logistic regression model had area under the curve (AUC) values of 0.903 and 0.803, respectively. Significant risk factors identified included gender, race, family history of diabetes, type of diabetes treatment, cholesterol levels, triglyceride levels, high-density lipoprotein (HDL) levels, and duration of diabetes. Notably, women, patients with a family history of diabetes, and those using injectable or combined injectable and oral medications were at higher risk of developing neuropathy. CONCLUSION: These findings highlight the importance of vigilant monitoring and proactive management of neuropathy risk factors, especially in women, patients with a family history of diabetes, and those using injectable or combined diabetic medications.

Predictors of Marital Satisfaction Among Reproductive-Age Women Based on Personality Traits: A Study in Iran.

BACKGROUND AND OBJECTIVE: Marital satisfaction is a complex phenomenon influenced by a variety of factors, including personality traits, communication, conflict resolution, and economic stability. This study aims to examine the relationship between personality and marital satisfaction among reproductive-age women, exploring how these factors interplay and contribute to the overall dynamics of marital relationships. MATERIALS AND METHODS: A cross-sectional study was conducted among reproductive-age women to assess marital satisfaction and personality traits using established assessment tools. The demographic data were collected through a structured questionnaire, and the relationship between personality traits and marital satisfaction was analyzed using confirmatory factor analysis (CFA). Regression models were used to identify significant predictors of marital satisfaction, and the fit of the CFA model was evaluated using various indicators. RESULTS: The mean age of the participants was 33.7 (±8.09) years, while the mean age of their husbands was 38.3 (±9.27) years. The results showed that conscientiousness and agreeableness had significant positive associations with marital satisfaction. Communication and conflict resolution emerged as key components of marital satisfaction, with standardized coefficients of 0.894 and 0.818, respectively. Financial management was also found to be strongly related to marital satisfaction, indicating the importance of economic stability in maintaining marital harmony. CONCLUSION: The study underscores the significance of personality traits, communication, conflict resolution, and financial management in shaping marital satisfaction among reproductive-age women. The results suggest that interventions targeting improved communication and effective conflict-resolution strategies can enhance marital satisfaction. Additionally, addressing financial stressors and promoting economic stability could lead to better marital outcomes. These findings align with previous research, highlighting the need for a holistic approach to understanding and improving marital satisfaction. Further research is recommended to explore these relationships in different cultural contexts and with broader demographic groups.

Application of Mixture and Non-mixture Cure Models in Survival Analysis of Patients With COVID-19.

Background Due to the emergence of new COVID-19 mutations and an increase in re-infection rates, it has become an important priority for the medical community to identify the factors affecting the short- and long-term survival of patients. This study aimed to determine the risk factors of short- and long-term survival in patients with COVID-19 based on mixture and non-mixture cure models. Methodology In this study, the data of 880 patients with COVID-19 confirmed with polymerase chain reaction in Fereydunshahr city (Isfahan, Iran) from February 20, 2020, to December 21, 2021, were gathered, and the vital status of these patients was followed for at least one year. Due to the high rate of censoring, mixture and non-mixture cure models were applied to estimate the survival. Akaike information criterion values were used to evaluate the fit of the models. Results In this study, the mean age of the patients was 48.9 ± 21.23 years, and the estimated survival rates on the first day, the fourth day, the first week, the first month, and at one year were 0.997, 0.982, 0.973, 0.936, and 0.928, respectively. Among the parametric models, the log-logistic mixed cure model with the logit link, which showed the lowest Akaike information criterion value, demonstrated the best fit. The variables of age and prescribed medication type were significant predictors of long-term survival, while occupation was influential in the short-term survival of patients. Conclusions According to the results of this study, it can be concluded that elderly patients should observe health protocols more strictly and consider receiving booster vaccine doses. The log-logistic cure model with a logit link can be used for survival analysis in COVID-19 patients, a fraction of whom have long-term survival.